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Here is a full summary of all 5 documents for Mrs. Simron Kumari, 19Y/F, seen at East Point Hospital, Bangalore on 29 July 2026.
Patient: Simron Kumari | 19 Years, Female | UHID: EPH260000086121
Department: Gynaecology | Consultant: Dr. Gynaecology Unit
1. CBC (Complete Blood Count)
| Parameter | Result | Reference | Status |
|---|---|---|---|
| Haemoglobin (Hb) | 11.1 g/dL | 11.5 - 16 | ⚠️ Low |
| Total WBC Count | 15.23 × 10³/µL | 4 - 11 | ⚠️ High (circled) |
| Neutrophils | 77.3% | 40 - 70 | ⚠️ High |
| Lymphocytes | 11.5% | 17 - 40 | ⚠️ Low |
| Monocytes | 7.4% | 0 - 10 | Normal |
| Eosinophils | 3.6% | 1 - 5 | Normal |
| Basophils | 0.2% | 0 - 1 | Normal |
| RBC | 3.43 × 10⁶/µL | 4 - 5.4 | ⚠️ Low |
| HCT/PCV | 31.3% | 40 - 52 | ⚠️ Low |
| MCV | 91.3 fL | 77 - 97 | Normal |
| MCH | 32.4 pg | 26 - 34 | Normal |
| MCHC | 35.5 g/dL | 33 - 36 | Normal |
| RDW-CV | 15.0% | 9 - 14.5 | ⚠️ High |
| Platelet Count | 247 × 10³/µL | 150 - 450 | Normal |
| ESR | 70 mm/hr | 0 - 20 | ⚠️ Very high |
Key CBC findings:
- Mild anaemia (Hb 11.1, normocytic pattern with slightly elevated RDW suggesting possible mixed deficiency or early iron/folate deficiency in pregnancy)
- Leukocytosis (15.23) with neutrophilia (77.3%) - can be physiological in pregnancy but may also reflect infection/inflammation
- Raised ESR (70) - expected to be elevated in pregnancy, but significantly elevated and needs correlation
- Low lymphocytes (11.5%) - relative lymphopenia
2. Obstetric Sonography (USG)
LMP: 25/12/2025 | GA by LMP: 30 weeks 6 days | EDD by LMP: 01/10/2026
Observations
- Single live intrauterine fetus, cephalic presentation
- Cardiac activity: Normal, HR = 132 bpm
- Placenta: Anterior wall
- Liquor: Just adequate, AFI = 8.7 cm (lower limit of normal; normal 8-18 cm)
- Cervix: 3.3 cm, internal os closed
Fetal Biometry
| Measurement | Value | Gestational Age |
|---|---|---|
| BPD | 7.39 cm | 29 weeks 5 days |
| HC | 27.24 cm | 29 weeks 5 days |
| AC | 25.49 cm | 29 weeks 5 days |
| FL | 5.75 cm | 30 weeks 1 day |
- EFW: 1460 ± 213 g (average GA = 29 weeks 6 days)
- EDD by USG: 08/10/2026
- EFW percentile: ~12.5th - suggests mild fetal growth restriction (FGR)
Doppler Evaluation
| Vessel | PI | Percentile |
|---|---|---|
| MCA (Middle Cerebral Artery) | 2.62 | 93rd |
| UA (Umbilical Artery) | 1.35 | 84th |
| Cerebro-Placental Ratio (CPR) | 1.94 | 36th |
Doppler impression: Within normal limits. MCA PI is high (good brain perfusion), UA PI is also elevated but reportedly normal. CPR > 1 is reassuring.
Overall USG Impression
- Single live intrauterine fetus of ~30 weeks in cephalic presentation with good cardiac activity
- Colour Doppler indices for MCA & UA within normal limits
- Liquor just adequate - follow-up suggested
3. Ultrasound Images (Printed Films)
The films show:
- AFI quadrant measurements: Q1 = 1.89 cm, Q2 = 3.59 cm, Q3 = 2.70 cm, Q4 = 0.53 cm → AFI = 8.71 cm
- Umbilical artery Doppler waveforms with S/D = 4.40, PI = 1.35, RI = 0.77, HR = 130 bpm
- Fetal body image showing AC = 25.49 cm, EFW = 1460g at 29w5d (12.5th percentile)
- MCA Doppler: PI = 2.62, RI = 1.00, HR = 126 bpm, S/D = 505.29
- FL measurement: 5.75 cm, GA 30w1d (FL/BPD = 78%, FL/HC = 0.21)
Summary of Clinical Concerns
| Finding | Significance |
|---|---|
| Hb 11.1 g/dL | Mild anaemia in pregnancy - needs iron/folate supplementation monitoring |
| WBC 15.23, Neutrophilia 77.3% | Leukocytosis - physiological in pregnancy or may indicate infection |
| ESR 70 mm/hr | Markedly elevated - needs clinical correlation (infection, inflammation) |
| EFW 1460g at ~30 weeks (12.5th %ile) | Suggestive of mild fetal growth restriction (FGR) |
| AFI 8.71 cm | Low-normal amniotic fluid - borderline oligohydramnios; follow-up advised |
| UA PI 1.35 (84th %ile) | Elevated but not absent/reversed; Doppler currently reassuring |
| CPR 1.94 (36th %ile) | Within normal range (>1), but watch trend |
Overall: This is a 19-year-old primigravida at approximately 30 weeks gestation with mild anaemia, a mildly growth-restricted fetus with borderline liquor. Dopplers are currently normal, which is reassuring. Close monitoring with serial growth scans and Doppler assessments is warranted. The treating gynaecology team should evaluate the leukocytosis and elevated ESR for any underlying infection.
⚠️ This is a document summary for informational purposes only. All clinical decisions must be made by the treating physician.
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